Credentialing Specialist - Hawaii

Job Summary

Managing the full scope of provider credentialing and payer enrollment functions, the full-time Credentialing Specialist - Hawaii will ensure compliance with regulations and support timely provider onboarding while working remotely.

Key responsibilities

• Coordinate the end-to-end process of initial credentialing, recredentialing, and payer enrollment for healthcare providers
• Ensure accurate documentation and maintain audit-ready digital files in compliance with internal policies and standards
• Serve as the liaison among provider onboarding, medical staff services, and revenue cycle departments to track credentialing progress

Required qualifications

• Minimum of two (2) years of experience in provider credentialing or payer enrollment in a healthcare setting
• High School Diploma or General Education Development (GED) required
• Proficiency with CAQH, PECOS, NPPES, and payer enrollment portals
• Familiarity with CMS regulations and Hawaii-specific Medicaid requirements
• Experience with credentialing software preferred